Spleen Preserving Radical Gastrectomy with D2 Lymphadenectomy

The question how to operate gastric cancer is still very actual. In literature we can find many controversies about the volume of needed dissection. As I believe D2 LN dissection is very important to reach oncologically adequate result. It is not only useful for staging of disease. In the huge group of patients it really improves survival and creates a basis for more effective postoperative chemotherapy.

The fact is that too much surgeons declare but really not perform this operation. I listened to J.M.Collard the outstanding Belgian surgeon in Bangkok IASGO meeting. He has a great experience in GI surgery. He really believes in Japanese-like D2 lymphnode dissection. Also he said in his lecture that he knows only several specialists in Europe who do it really, not N1+ procedure. It was a motivation to make this movie.

This film describes the technique of spleen preserving gastrectomy with D2 lymphnode dissection for gastric carcinoma. The reconstructive procedure is Uncut-Roux with reservoir. The purpose of this video is to describe how to perform this surgery more carefully and safely. The vessel approach, working in anatomical layers following mainline arteries and veins is a key of fully adequate lymphadenectomy and the way to operate in the safe mode in order to prevent intraoperative and postoperative surgical complications. All steps of this operation are fully described and accompanied with subtitles in this film.

Video by Ilya Gotsadze (M.D., Ph.D.)